Background: Respiratory distress is recognized as any signs of breathing difficulties in neonates. In the early neonatal period respiratory distress is common, occurring in up to 7% of newborn infants, resulting in significant numbers of term-born infants being admitted to neonatal units. Multiple conditions can present with features of respiratory distress. High frequency ventilation (HFV) has proved its unique efficacy in the treatment of acute respiratory distress, when conventional mechanical ventilation (CMV) has demonstrated a limited response. HFV was introduced in clinical practice in the early 1970s.